MR扩散张量成像对Chiari畸形脊髓损伤的诊断价值  

Value of diffusion tensor imaging in the diagnosis of spinal cord injury in Chiari malformation

作　　者：张飘尘[1] 范光明[1] 焦俊[1] 沈金丹[1] 阮志兵[1] 

机构地区：[1]贵阳医学院附属医院影像科,贵州贵阳550004

出　　处：《实用放射学杂志》2014年第1期39-43,共5页Journal of Practical Radiology

摘　　要：目的探讨MR扩散张量成像（diffusiontensorimaging，DTI）评价Chiari畸形的价值。方法对20例健康志愿者及20例Chiari畸形的患者行颈髓DTI成像，在志愿者C2～C3、C4～C5、C6～C7节段水平、Chiari畸形患者受压颈延髓层面及每位健康志愿者的相应层面于矢状面选取感兴趣区（regionofinterest，ROI），分别测量表观扩散系数（apparentdiffusioncoefficient，ADC）值、部分各向异性（fractionalanisotropy，FA）值，并行神经纤维束示踪成像（diffusiontensortractography，DTT）。结果①健康志愿者C2-C3、C4--C5、C6～c7节段水平ADC值差异及FA值差异均无显著性（P〉O．05），平均ADC值及FA值分别为（O．759±0．058）×10-3mm2／s、0．688±0．055。②无症状组Chiari畸形患者受压颈延髓的ADC值[（0．839±0．076）×10-3mm2／s]、FA值（O．748±0．062）分别与健康志愿者相应层面的ADC值、FA值相比无明显统计学意义（P〉0．05）。③有症状者Chiari畸形患者受压颈延髓的ADC值[（O．956±0．062）×10-3mm2／s]、FA值（0．520±0．047）与健康志愿者相应层面的ADC值、FA值相比分别增大、减小（P〈O．01）。结论DTI能够很好地显示Chiari畸形患者受压颈延髓的内部变化，其ADC值、FA值改变与颈延髓受压程度及临床症状存在相关性。Objective To explore the value of MR diffusion tensor imaging （DTI} in evaluating Chiari malformation. Methods Twenty healthy volunteers and 20 patients with Chiari malformation underwent the DTI of cervical cord. The measured regions of interest {ROIs） were chosen in the levels of C2--3, C4--5 and C6--7 in volunteers, in compressed cervical spinal cord and medulla oblongata in patients and in the same levels in volunteers in saggital plane. The apparent diffusion coefficient （ADC） and fractional anisotropy （FA} values were measured in every ROI, and then diffusion tensor tractography {DTT} of cervical cord were per- formed. Results The differences of ADC and FA values among the levels of C2--3, C4--5 and C6- 7 in volunteers were not statisti- cally signifieant（P〉0.05）with an average ADC value {0. 759±0. 058） X 10-amm2/s and FA value 0. 688±0. 055. There were no statistical differences in ADC and FA values between in compressed cervical spinal cord and medulla oblongata in asymptomatic pa- tients and in the same levels in volunteers（P〉0.05）. The ADC value[（0. 956 ±0. 062） X 10-a mm2/s-]increased in compressed cer vical spinal cord and medulla oblongata in symptomatic patients, whereas the FA value （0. 520 ±0. 047） decreased, compared with those in the same levels in volunteers（P〈O. 03 ）. Conclusion DTI can properly demonstrate the changes of ADC and FA values in compressed cervical spinal cords and medulla oblongatas in patients with Chiari malformation, and these changes are relevant to the compression degree and symptom.

关 键 词：CHIARI畸形 颈髓 扩散张量成像 磁共振成像 

分 类 号：R742.82[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]